Alginates and Antacids

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Andrew Street
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Give eg's & indications for alginates & antacids. eg's: Gaviscon®, Peptac® Indications: • Gastro-oesophageal reflux disease - relief of HT burn • Dyspepsia - short-term relief of indigestion
MOA of alginates & antacids. These drugs are most often taken as compound preparations containing an alginate with one or more antacids, such as sodium bicarbonate, calcium carbonate, magnesium or aluminium salts. Antacids work by buffering stomach acids. Alginates act to increase the viscosity of the stomach contents, which reduces the reflux of stomach acid into the oesophagus. After reacting with stomach acid they form a floating ‘raft’, which separates the gastric contents from the gastro-oesophageal junction to prevent mucosal damage. There is some evidence to suggest they also inhibit pepsin production. Antacids alone (usually aluminium or magnesium compounds) can be used for the short-term relief of dyspepsia.
SE's of alginates & antacids. • Diarrhoea (magnesium salts) • Constipation (aluminium salts)
CI's, cautions, & important interactions of alginates & antacids. CI's: • None Cautions: • Compound alginates should not be given in combination with thickened milk preparations (for paeds) as can lead to thick stomach contents that cause bloating & abdo discomfort • Sodium & potassium containing preparations should be used with caution in pt's with fluid overload or hyperkalaemia eg renal failure Important interactions: The divalent cations in compound alginates can bind to other drugs, reducing their absorption. Antacids can reduce serum concentrations of many drugs, so the doses should be taken at different times. This applies to ACEi's, some antibiotics (e.g. cephalosporins, ciprofloxacin & tetracyclines), bisphosphonates, digoxin, levothyroxine & PPI's. By ^alkalinity of urine, antacids can ^excretion of aspirin & lithium.
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